Two cases of measles confirmed in Mass.

Two cases of highly contagious measles have been confirmed in the suburbs west of Boston, the Massachusetts Department of Public Health said Monday, and Framingham health officials later issued a public health alert warning residents that they may have been exposed to the disease if they shopped at the Trader Joe’s on Route 9 in Framingham on Feb. 15 or 16.

Most people in the United States have been vaccinated against measles or were exposed as children, making them immune. But health officials are advising those who think they may have been exposed and who are experiencing symptoms of measles to avoid health care facilities because of the risk that they may potentially expose others; they are urged to call their doctor instead.

When the Framingham Board of Health became aware that there was a measles exposure at Trader Joe’s last week, the head nurse jumped on it very quickly, board chairman Micheal Hugo said in a phone interview Monday night.

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Two clinics were held at the store where free measles vaccinations were available to employees and anyone who believed they may have been exposed, he said.

“Measles is a highly contagious disease. We want to make sure we can get the immunization into people who were exposed as soon as possible,” Hugo said.

The chairman explained that there is a very short window when those who have been exposed can be vaccinated before the disease takes over the body.

“The vaccine is extremely effective,” he said.

Symptoms of the measles appear 10 days to two weeks after exposure and can be similar at first to those of a cold, including fever, cough, runny nose, and red eyes. Two to four days after the initial symptoms, a rash may appear for a few days and then disappear. Individuals with the measles are considered contagious up to four days before and after the rash appears.

The measles is spread more easily than almost any other disease, according to the Department of Public Health—mainly through airborn transmission such as breathing, coughing, and sneezing.

The last confirmed cases of the measles in Massachusetts occurred in August 2013. The Boston Globe reported that hundreds of residents may have been exposed when an infected individual walked into a clinic at Massachusetts General Hospital seeking treatment. A few days later, another individual sought treatment for measles at MetroWest Medical Center in Framingham.

The measles were officially eliminated in the United States in 2000 because of widespread vaccination, but the disease continues to spread worldwide. An average of about 60 people in the United States contract measles every year, according to the federal Centers for Disease Control and Prevention, mostly from people exposed in other countries who then travel here.

But in 2013, 159 people contracted the measles between January and August, the CDC reported. Seventeen of those cases required hospitalization, but none died.

According to the Massachusetts Department of Public Health, people who may be in danger of contracting the measles if exposed are:

-- Infants and young children who have not received their first dose of the measles-mumps-rubella (MMR) vaccine at 12 to 15 months of age.

-- School-age children who have not received their second dose of the MMR vaccine.

-- Adults who have not received at least one dose of the MMR vaccine. Health officials recommend that even adults born before 1957, who are considered to be immune because the measles was then a widespread childhood disease in the United States, may benefit from an MMR vaccine.

International travelers, health care workers, and college students are considered a high-risk population of people who may require an additional MMR vaccination.